Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 23430 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Move Tendon In Upper Arm, Surgery To Cut The Normal Attachment Of The Biceps Tendon On The Shoulder Socket And Reattach It To The Arm Bone. The Procedure Treats Biceps Tendon Inflammation Or Injury.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 23430 |
| Medicaid Fee Schedule | View Medicaid rates for 23430 |
National average reimbursement for CPT 23430 by major payers:
$974.78
$1,007.95
$1,065.45
$1,227.18
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 23430.
CPT 23430
5 of 25 sample ratesHigher to lower in this preview
Metropolitan Medical Partners LLC, Surgery Center Of Chevy Chase
Metropolitan Medical Partners Ll
$5,249.00Published rateTalisa Forest
$2,016.47Published rateChildren'S Eye Care Of Northern Colorado PC
$1,053.01Published rateArwen Christian
$864.40Published rateLucy Mudie
$623.21Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 23430 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 23430 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 23430 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 23430-CPT | Moderate | Move Tendon In Upper Arm, Surgery To Cut The Normal Attachment Of The Biceps Tendon On The Shoulder Socket And Reattach It To The Arm Bone. The Procedure Treats Biceps Tendon Inflammation Or Injury. |
| 23440-CPT | Moderate | Surgery On Upper Arm Tendon, Surgery To Remove Biceps Tendon From Original Attachment On Shoulder Socket And Transplant To Upper Arm Bone. |
| 23450-CPT | High | Capsulorrhaphy Anterio; Putti-Platt Proc Or Magnuson Typ Opera, Capsulorrhaphy Anterior; Putti-Platt Procedure Or Magnuson Type Opera |
| 23455-CPT | High | Repair Shoulder Capsule, Reattachment Of Shoulder Joint Capsule And Cartilage Without Bone Transfer With Repair Of Shoulder Rim |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 23430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 23430 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 23430) and we'll show you how you compare in 15 minutes or less.